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Ontario will move soon to control soaring wages of top health-care executives across the province, Health Minister Deb Matthews says.

But Matthews claims she was powerless to regulate or stop whopping pay raises awarded in recent years to senior executives at Community Care Access Centres, which govern home care in Ontario. Some of the raises topped 50 per cent over a three-year period.

“Where there have been rules put in place, we ensure those rules have been followed,” Matthews said in response to a series of questions I put to her.

“Going forward, our government has committed to introduce legislation early this year to directly control the compensation of senior executives across the broader public sector, including sector-specific salary caps.”

Matthews was replying to issues raised in a series of columns that detailed evidence of huge executive pay raises, a mounting culture of fear in all parts of the system, and major cuts in critical health-care services, especially in parts of the home-care field.

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In 2012, the average salary of chief executive officers at the 14 CCACs in Ontario was $234,000. That is the latest year such figures are available.

In contrast, many health-care workers, such as personal support workers, earn less than $20,000 and haven’t had a raise in years – and many have seen their income drop in the past decade.

Matthews suggested her hands were tied when it came to CCAC pay scales because compensation decisions are made by the local board of directors. CCACs are non-profit agencies, overseen by community boards and reporting to their Local Health Integration Network (LHIN).

While they enjoyed huge raises, CCAC executives supposedly were to be part of a broader public sector salary freeze from March 2010 to March 2012. The only way their pay could rise was if the increase was part of an existing compensation plan or if a new CEO was hired.

Despite those rules, almost all 14 CCACs gave their CEOs raises of more than 30 per cent between 2009 and 2012.

Interestingly, Matthews did not respond to a question about whether she felt the wage increases — some up to $90,000 a year — were justified when most front-line workers didn’t get a raise at all during the same period.

Also, Matthews didn’t comment on whether she would agree to a full audit of CCAC finances and a full review of CCAC operations, as many health-care experts are requesting. Many are urging Queen’s Park to disband the CCACs, which oversee $2.2 billion in home-care funding, and shift the work to the LHINs or local health agencies.

Matthews is under heavy attack for her handling of the health-care portfolio. Critics argue she is overseeing a system that is declining rapidly and requires major reform and that she has failed to act decisively to stem the rot.

In particular, they point to CCACs as bureaucratic nightmares that waste money, overmanage front-line workers and act as all-powerful “gatekeepers,” arbitrarily cutting funding for some services, notably rehabilitation, or refusing to allow patients more than two or three home visits by a health-care professional in order to save money.

Matthews said 91.3 cents of every dollar CCACs receive go directly to delivering services to patients.

In fact, though, barely 50 cents or less of every dollar reaches front-line workers who actually treat patients. Some 30 cents is gobbled up in CCAC administrative and care coordination cost and another 20-30 cents goes for overhead and profits for private firms contracted to deliver the services.

Such criticism also extends to the LHINs, where CEO salaries often top $300,000 a year.

LHINs, which are funded by the province, were created in 2006 to plan, fund and co-ordinate services delivered by hospitals, CCACs, community support service agencies, mental health and addiction agencies, and community health centres. They oversee more than $21 billion a year in health-care dollars.

A former top LHIN executive, who asked not to be named, said in a telephone interview this week that the LHINs are as much of a mess as CCACs, with too much bureaucracy, soaring salaries for top bosses, a lack of coordination between individual LHINs and no accountability to Queen’s Park.

“None of the LHINs has been called to task,” said the former executive, who until recently oversaw multimillion-dollar budgets. “Matthews has done nothing, even though none of them has reached their targets for the last two years.”

For her part, Matthews insisted “tremendous gains” have been made in home care and that she’s open to looking at how to better deliver services at home and in the community.

But Matthews has lost the confidence of too many health-care experts, front-line workers and patients to be granted unfettered power to allow the CCACs and LHINs to operate as they have in recent years.

That’s why Premier Kathleen Wynne needs to be actively involved in the health portfolio — and why she needs to order a full audit and review of CCAC and LHIN operations.

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